Fungal meningitis cases in Michigan climb to 164; death total at 10

Some 478 cases of fungal meningitis have been reported by federal health officials in the nation with 164 of those in Michigan.

The death toll nationwide has reached 34, including 10 in Michigan, according to the Center for Disease Control and Prevention.

Michigan leads the nation in the number of cases and deaths. Nineteen states have reported fungal meningitis cases.

The Michigan cases include 64 people with meningitis, 91 with an epidural abscess, one stroke and eight joint infections, according to the Michigan Department of Community Health on Friday.

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One of the 10 Michigan deaths was from stroke following the occurrence of fungal meningitis, officials said. Three additional Michigan resident deaths are being counted as Indiana cases because that's where treatment occurred.

The dead include four residents of Livingston County, two in Washtenaw County and one each in Ingham, Charlevoix, Genesee and Wayne counties. Those who died ranged in age from 50 to 88. One victim was a male with the rest being women.

The outbreak was tied to methylprednisolone acetate steroid injections used to treat pain that were made by the specialty pharmacy, the New England Compounding Center in Framingham, Mass.

The CDC said it was still receiving reports of infections more than seven weeks after the September recall of more than 17,000 vials of injections of the steroid made by the NECC. However, the pattern now reflects an uptick in infections at the site where patients received the injection.Those infections include epidural abscesses, phlegmon (soft tissue infection), discitis (infection of disc space between vertebrae), vertebral osteomyelitis (a bone infection) or arachnoiditis (swelling of one of the spinal cord membranes), the CDC said.

The infections are being found in both people who have already been diagnosed with fungal meningitis and people who haven't been. The CDC said there may not be new infections in those people, but because the fungus tied to the outbreak -- Exserohilum rostratum -- is slow-growing, the infections may have been building up.

"This isn't something new happening, but something that's coming to light after a much longer incubation period," Dr. J. Todd Weber, incident manager for response to the fungal meningitis outbreak and chief of prevention and response at the CDC's division of healthcare quality promotion,

Last week, House lawmakers questioned Dr. Margaret Hamburg, chief of the Food and Drug Administration along with one of the owners of the New England Compounding Center, Barry Cadden, about the current outbreak. They asked about the company's history of repeat violations and earlier FDA inspections of the firm that found non-sterile practices.

Hamburg called for more oversight of compounding pharmacies, which are regulated by state health departments, while Cadden pleaded the Fifth Amendment and did not answer the committee's questions.